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Home My WebLink AboutZ-29577FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 29577 THIS CERTIFIES that the building DWELLING Date: 07/16/03 Location of Property 13905 MAIN RD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 140 Block 0003 Lot 029 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 29577 dated JULY 16, 2003 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH ACCESSORY THREE CAR GARAGE The certificate is issued to SOPHIE JEROME of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 (OWNER) N/A N/A N/A hor' ed Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 13905 MAIN RD MATTITUCK SUBDIVISION: NAP NO.: IAT (S) NAME OF OWNER (S): SOPHIE JEROME OCCUPANCY: SINGLE FAMILY DWELLING SOPHIE JEROME ADMITTED BY: THEODORE SWANSON ACCOMPANIED BY: SAME KEY AVAILABLE: BUFF. CO. TAY MAP NO.: 140.-3-29 SOURCE OF REQUEST: CHARLES E. RAFFEE, ATTY 7/8/03 DATE: 07/16/03 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 2.0 # EXITS: 3 FOUNDATION: CEMENT BLOCK CELLAR: FULL CRAWL SPACE: TOTAL ROOMS: 1ST FLR.: 3 2ND FLR.: 3 3RD FLR.: 0 HATHROOM(S): 2.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: COVERED RAISED PATIO BREEZEWAY: FIREPLACE: ONE GARAGE: DOMESTIC HOTWATER: YES TYPE HEATER: OFF BOILER AIRCONDITIONING- TYPE BRAT: OIL WARM AIR: HOTWATER: XX OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF COMET.: 3 CAR WOOD FRAME STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE INSPECTED BY:- DATE ON INSPECTION: 07/15/03 GARY IS TIME START: 10:20 AM END: 10:45 AM Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT, JILL _ $ 2003 TOWN HALL 765-1802 { APPLICATION FOR CERTIFICATE OF O`n This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage -disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non -conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. ,2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. July 7, 2003 New Construction: Old or Pre-existing Building: X (check one) Location of Property: 13095 Plain Road 11attituck House No. Street Hamlet Owner or Owners of Property: Sophie Jerome Suffolk County Tax Map No 1000, Section 140.00 Block 03.00 Lot 029.000 Subdivision N/A Filed Map. N/A Lot: N/A Permit No. N/A Date ofPerrnit. N/A Applicant: N/A Health Dept. Approval: N/A Underwriters Approval: N/A Planning Board Approval: N/A Request for: Temporary Certificate N/A Fee Submitted: $ 100.00 Q.ec, b y 3 // 6V rd -f_ aqs ,7 7 Final Certificate: N/A (check one) '�yQ lz J Applicant ig ature SOPHIE JERO?4E BY ANNE J. SWANSON, ATTORNEY—IN—FACT CONSENT TO INSPECTION SOPHIE JEROME the undersigned, do(es) hereby state: Owner(s) Name(s) That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold, located at 13095 Main Road, Mattituck which is shown and designated on the Suffolk County Tax Map as District 1000, Section Block Lot That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: to obtainh a Certificate of Occupancy on Pre -Existing Building That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws, ordinances, rules or regulations of the Town of Southold. A= Dated: July 7, 2003 SOPHIE J&1e �ffe)MM J. S;WSON, ATTORNEY-IN-FACT (Print Name) (Signature) (Print Name) CHARLES E. RAFFE ATTORNEY AND COUNSELLOR AT LAW ,a7 EAST SLAIN STREET F. O. RON 29n RIA'ERHEAD, NENYORK 10101 631-727-3662-3 TELECOF ER NO: 631-727-2761 ESSERS, HEFTER & .AN(iM, SOLOMON RAFFE OF cooNSEL July 7 2003 111011-19M1 Town of Southold Building Department Southold Town Hall Main Road Southold, New York 11971 Re: Sophie Jerome to Joseph S. Grattan and Tracey Grattan Premises: 13905 Main Road, Mattituck, New York Dear Sir or Madam: I represent Sophie Jerome who is in the process of selling her home located at 13905 Main Road, Mattituck, new York. In connection therewith, please find enclosed herewith the following: 1. Mrs. Jerome's Application for a Certificate of Occupancy for Pre -Existing Building executed by her daughter, Anne J. Swanson, her Attorney -in -Fact. 2. A copy of the Power of Attorney of Mrs. Jerome appointing Mrs. Swanson her Attorney -in -Fact. 3. The executed Consent to Inspection Form. 4. An original current -dated survey print of the subject premises. 5. My Office Check for $100.00 to the Town of Southold for the Application Fee. Please be advised that you should call Anne J. Swanson or her husband, Theodore Swanson at 765-5735 to arrange for access to the subject premises. 1 Trusting your find these enclosures satisfactory, please process my client's Application at this time. Ver y trruuly yours, r CHARLE RAFFE CER/mg Enclosures CC: Anne J. Swanson and Theodore Swanson 2 00W or N G \-OrfCtne N N M N\N RU N� 0 - NONUMENT SET 0 - MONUMENT FOUND A - STAN[ SET ♦ = STAKE vourvo 0 - DRILL HOLE 4T E Young & Young 400 Ostrander Avenue, Riverhead, New York 11901 631-727-2303 Howard W Young, Land Suroeyor Thomas C. Wolpert, Professional Engineer Robert C. Tact, Architect Ronald E Pfuhl, Landscape Architect NOTE AREA = 26,652 SQ. FT. SURVEYOR'S CERTIFICATION • WE HEREBY CERTIFY TO JOSEPH S. GRATTAN, TRACEY A. GRATTAN, SUFFOLK COUNTY NATIONAL BANK & FIDELITY NATIONAL TITLE INSURANCE COMPANY OF NEW YORK THAT THIS SURVEY WAS PREPARED IN ACCORDANCE WITH TH_ `A PRACTICE FOR LAND SURVEYS ADOPTED BY W ASSOCIATION, OF PROFESSIONAL LAND SURV I, C HOWARD W. YOUNG, N.YS LS. NO 45893 SURVEY FOR JOSEPH S. GRATTAN & TRACEY A. GRATTAN At Mattituck, Town of Southold Suffolk County, New York County Tax MOP o,sEict 1000 s -i- 140 e., 03 sol 29 TITLE �IJFR�/E� MAP PREPARED JUNE 26, 2003 SCALE 1" = 30' TCS JOB NO. 2003-0231 I J DWG 2003_0231 _ts LOCATION: (number & street) SUBDIVISION: NAME OF OWNER(S): OCCUPANCY: MAP NO.: (municipality) LOT(S): (type) (owner -tenant) ADMITTED BY: ACCOMPANIED BY: �Z' � KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000 - SOURCE OF REQUEST: DATE: DWELLING: , Q TYPE OF CONSTRU TION: �`� �# STORIES: # EXITS: FOUNDATION: T CELLAR: CRAWL SPACE: TOTAL ROOMS: 1ST FLR: 33 2ND FLR: 3RD FLR: BATHROOM(S): TOILET ROOM(S): UTILITY ROOM: PORCH TYPE: DECK, TYPE: PATIO, TYPE: BREEZEWAY: FIREPLACE: ARAGE: DOMESTIC HOTWAr + R:$ TYPE HEATER: _ CONDITIONING: _------- TYPE HEAT: WARM AIR: HOTWATER: OTHER: 3 ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST: OTHER: VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION I DESCRIPTION I ART. I SEC. REMARKS: INSPECTED BY: DATE ON INSPECTION: % ll& TIME START: 0 = a0 END: TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET; VILLAGE DIST. SUB. LOT�211,,, vQ �a ro6ILL to �'��tva; pis FO ER OWNER N E' ACR. .... ....... . S W TYPE OF BUILDING SEAS. VL. FARM COMM. CB. MICS. Mkt.. Value LAND IMP. TOTAL DATE REMARKS -- & ;.. .. ` AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Acre Value Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROADgo Meadowland DEPTH House Plot BULKHEAD Total �./ �, �. `�-� DOCK